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. 2023 Aug 22;24(17):13038. doi: 10.3390/ijms241713038

Table 1.

Main metabolic pathways induced by hyperglycemia. AGE—advanced glycation end products; DAG—diacylglycerol; DKD—diabetic kidney disease; PKC—protein kinase C; ROS—reactive oxygen species; UDP-GlcNAc—uridine diphosphate-N-acetylglucosamine.

Pathway Main Substrate Main Product(s) Cellular Alterations
Polyol pathway glucose sorbitol; fructose - induction of osmotic and oxidative stress
- increased usage of NADPH
Hexosaminepathway fructose-6-phosphate UDP-GlcNAc - alterations in gene expression
- increased ROS production
- increased caspase-3 activity
PKC pathway dihydroxyacetonephosphate DAG - activation of PKC
- increased ROS production
- decreased nitric oxide
AGE pathway variable: proteins,
glucose, amino acids, metabolites
AGE - increased ROS production
- activation of inflammatory response
- decreased nitric oxide and taurine production